The invention relates generally to the management of the treatment of diseases in a multidisciplinary framework.
As advances in medical knowledge and techniques are made, the amount of information available when treating a patient, as well as the number of patient management options available, have steadily increased. As a result, patient management for many diseases may benefit from review of an ever-increasing amount of patient data in order to identify the most appropriate patient management options. Furthermore, the amount of data available to be considered is growing not only in quantity, but also in diversity, as, for example, new imaging technologies and drugs are introduced. As a result, no single clinician can have mastered the diversity of information to be considered in treating certain diseases.
For example, for diseases such as cancer, patient management may involve a team of clinicians spanning a range of specialisations. Such a multidisciplinary team (MDT), in the exemplary context of cancer patient management, may include one or more surgeons, radiologists, oncologists, clinical pharmacologists, pathologists, and so forth. The MDT may meet (this may be a face-to-face meeting, a teleconference, or an electronic meeting (e.g. over the internet)) regularly to collectively review a patient's clinical data and select the optimal patient management option. In this manner, the MDT can pool their expertise to jointly determine the next step in patient management. For these meetings to be effective, the team of clinicians should be presented with all of the data (such as patient records, imaging studies, drug information, and so forth) relevant to the decisions to be made. Further, accurate records should be kept of decisions made and the identities of the clinicians present.
Currently, MDTs collect the data necessary to make decisions for groups of patients by manually assembling the information that they believe is relevant to the decision making process and presenting it to the group of clinicians making the decision. Relevant information may be overlooked or unavailable at the time of the meeting, which may result in a delay in the meeting while the necessary information (such as radiological scans) is accessed or a delay in patient care due to postponement of a patient management decision until the next meeting. Alternatively, if such overlooked or unavailable information is not properly taken into account in the decision making process, an inappropriate patient management decision may be made due to the failure to consider all relevant information, including information that is not known or available, that might change the patient management decision.
In current practice, such team-analysis and/or team-decision making may be relatively informal and/or unstructured, with different team members being present at successive meetings and/or with little or no record of individual preferences or exceptions to the team's majority or consensual decisions. For example, a given discipline (such as surgery or oncology) may be represented by different individuals at different meetings such that new participants have little, very limited or insufficient history with the patient, and no recollections of previous discussions about the patient. Further, individual comments endorsing or disagreeing with the team decision are not typically noted, so future team meetings do not have the benefit of such prior discussion. Instead, it is currently assumed all members of the team support the final decision, with no mechanism in place for recording potential disagreements between specialists. In addition, the information the MDT bases its decision on may be incomplete or poorly organized, making proper analysis of the information difficult and/or inefficient. Despite this, the MDT is expected to review all aspects of the data, assess its potential impact on present and future clinical decisions, and ensure that errors due to information on which the decision is known to be contingent not being taken into account are minimized.
Further, the team decision process is typically not completely based on the latest evidence related to the disease. Likewise, there is no assurance that the most recent guidelines are followed to ensure the same standard of care for all patients. Instead decisions are often based upon the participant's specific experiences and knowledge, without regard to how representative the clinician's experiences or knowledge may be or to the biases in decision making that may be introduced by such reliance on personal experience. Further, when the latest guidelines are followed, they are often not sufficiently prescriptive and are sometimes contradictory. As such, they have to by supplemented with clinician preference.